title: [Diagnosis and surgical treatment of thoracolumbar vertebral Chance fractures caused by a fall].
abstract: OBJECTIVE
  To explore the diagnosis of Chance fractures of thoracolumbar spine and the clinical efficacy of segmental pedicle screw instrumentation in the treatment.
  
  
  METHODS
  The clinical data of 16 patients with Chance fractures from January 2000 to January 2007 were retrospectively analyzed. All patients were treated with segmental pedicle screw instrumentation. Radiology and the Oswestry Disability Index (ODI) were used to evaluate the efficacy.
  
  
  RESULTS
  One case associated with open dislocation of ankle and craniocerebral injury, 3 cases with calcaneus fracture and 1 with kidney contusion. All cases were followed up from 7 months to 6 years, with a mean of 2.6 years. There were no operation complications. The anterior vertebral body height of fracture vertebra was restored from preoperative (63.3 +/- 6.8)% to postoperative (92.1 +/- 4.0)%, at the follow-up (90.7 +/- 3.6)%. There was a significant improvement between preoperative and postoperative values (P < 0.01) and no difference between initial postoperative and final follow-up (P > 0.05). The mean ODI was 4.9.
  
  
  CONCLUSIONS
  The injuries associated with Chance fracture caused by a fall and its mechanism are different from those with the safety belt injury. The segmental pedicle screw instrumentation can rebuild spinal stabilization and restore spinal alignment in treatment of Chance fractures.
authors.affiliation: Department of Orthopaedic Surgery, First Affiliated Hospital of Soochow University, Suzhou 215006, China.
authors.forename: Gen-lin
authors.initials: GL
authors.lastname: Wang
authors.forename: Hui-Lin
authors.initials: HL
authors.lastname: Yang
authors.forename: Xin
authors.initials: X
authors.lastname: Cai
authors.forename: Jin-Hui
authors.initials: JH
authors.lastname: Shi
authors.forename: Tian-Si
authors.initials: TS
authors.lastname: Tang
mesh_terms: D000328:Adult; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000209:etiology / Q000601:surgery*; D013904:Thoracic Vertebrae / Q000293:injuries*; D016896:Treatment Outcome